There is often confusion about Memorial Day relative to Veterans Day, which was first observed in 1926, to recognize and appreciate all veterans who have served our country- particularly those who are still with us. Memorial Day, which began in 1868, is focused on honoring those individuals who have made the ultimate sacrifice preserving our country and the freedom for which it stands.

The first large observance for Memorial Day was held in 1866 at Arlington National Cemetery, across the Potomac River from Washington, D.C. Various Washington officials, including Gen. and Mrs. Ulysses S. Grant, presided over the ceremony. After speeches, children from the Soldiers’ and Sailors’ Orphan Home made their way through the cemetery, strewing flowers on both Union and Confederate graves, reciting prayers and singing hymns.

More than one million American servicemembers have died in wars since the first colonial soldiers took up arms in 1775. All Americans are direct beneficiaries of these sacrifices. Some specific actions you might take on this special day might include:

• Visiting memorials
• Visiting one of the 135 veterans’ cemeteries across the nation that protect the remains of our country’s fallen
• Flying the U.S. flag at half-staff until noon
• Volunteer or donate to non-profits serving survivors
• Reading to children about the meaning of the holiday. Some books that are appropriate for children four to eight include:
  • Memorial Day by Mir Tamim Ansary
  • Memorial Day Surprise by Theresa Martin Golding
  • The Wall by Eve Bunting

While this weekend is often considered the unofficial kickoff to summer, it’s important not to forget its true meaning and sentiment. We must never forget what these heroes have done and what their loved ones have lost.

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Magellan Federal has a long legacy of service to military survivors which dates back 1879. We are honored to be a leader in supporting military survivors, providing surviving military families with information and compassionate case management that helps them navigate a very complex set of issues and benefits.

A major trend in the pharmacy space continues to be increasing specialty drug spend, which is expected to continue with the introduction of new specialty agents for oncology, autoimmune disorders and rare diseases. In this year’s Medical Pharmacy Trend Report Employer Group Supplement, we found that 88 percent of employers reported a medical benefit spend of less than $10 million, and a year-over-year drug trend between 1-20 percent. For the few employer groups with spend above $10 million, it was due to a higher number of lives, and may be assumed that the employee mix for these groups may have included those with more costly health expenditures.

The Employer Group Supplement assists employer groups and third-party administrators in determining specialty drug trends and strategies to solve complex challenges impacting the medical benefit drug landscape. Our goal is to expand the information shared with employer groups to create a more dynamic picture of specialty drug management and help employers make more effective healthcare decisions. Building an effective medical benefit drug management strategy requires an in-depth knowledge of and expertise in this complex area, but it’s essential to help employers rein in costs and improve the quality of care for members. It is our hope that the survey data presented in this report helps employer groups begin to think about and investigate escalating medical pharmacy costs.

Download the full report or listen to our webinar to learn more.

Source: https://www.womenshealth.gov/nwhw/tools/infographics/mental-health/

Being a parent is one of the most challenging and rewarding jobs an individual can hold. When behavioral health challenges are added, it becomes even more difficult. Try, for a moment, to imagine being a foster parent to a child with behavioral health challenges. Where does one even begin to find the help and services they need to best care for their child?

Through our collaboration with the Wyoming Department of Health, Division of Healthcare Financing (Medicaid), Magellan in Wyoming coordinates care, including behavioral health interventions with other youth serving agencies in our system, using the High Fidelity Wraparound (HFWA) model to build a team of support for the successful management of complex conditions and behaviors in home- and community- based settings. The team creates steps to help youth stay in their homes, schools and communities. Through the 10 guiding principles of the program, families and youth have a voice in their care and choice in the kind of care they receive. We help to strengthen community support, understanding, and education of at risk youth ages 4-20 with complex behavioral health needs.

Magellan in Wyoming recently had the opportunity to hear from a former foster parent and HFWA graduate to discuss how the program benefited them through their challenges and supported their growth. “Opening my heart up to love and attachment with these children, parenting them with unconditional love, all the while knowing, they might not stay was difficult,” said the foster parent.

The siblings involved and their foster family cycled through numerous foster care workers in three years, creating more trauma for everyone. There was no stability and no consistency. Dealing with several different mental health diagnoses and many weekly appointments, in addition to the strain of everyday life, took a toll.

When this family discovered HFWA, they were naturally a little skeptical. They had experienced enough “new” things; however, this was the beginning of a completely new outlook on life. From the very start, HFWA taught the foster parent that it was okay to take a breath, to sleep and to ask for support. More importantly, it became evident that people wanted to help and be on the family’s team to help support them.

The family had spent so much time triaging the risk aspects of their children’s lives, that it had drained them of most of their hope. Through the strengths-based principles of the HFWA program, the family was able to gain new insight into ways they could focus on the local supports available to help them.

The program taught them to see the progress. By forming a HFWA team around the foster children and the whole family, they were able to gain some positive, strengths-based perspective along with stability and consistency.

HFWA empowered the family to have a voice and to use it effectively. “I knew all the people on my team before HFWA, but the program taught me how to use my voice. It taught me how to say what was going on and who to say it to,” said the foster parent. It was because of the family’s team, as well as community investment in the program, that today, the family is enjoying a life full of hope and possibility.

As a former Medicaid recipient who relied on treatment from community behavioral health centers, I know first-hand the transformative power a peer specialist can have a in a person’s life.

In my late teens and early twenties, I bounced from state hospitals to crisis stabilization units desperate to end my life. I had no hope that the goals I had envisioned prior to these struggles could be realized. When I started working with a peer specialist, I began to view myself and my future in a more positive light. My peer specialist expected me to recover and connected me to the resources and supports that empowered my recovery process. The painful experiences of my past paired with skills and knowledge of the healthcare system have provided me a platform for me to help others while creating lasting change. The opportunity to do such meaningful, passion-filled work for more than 40 hours of my week keeps me inspired and grateful to be a part of helping our members’ lead healthy and vibrant lives.

The work we do through Magellan Complete Care of Florida’s peer navigation program is literally changing the trajectory of peoples’ lives. Peer support offers hope to the hopeless. It helps our members see new possibility in a life that feels limited. I often tell the team that they have the hardest job in healthcare, as the members we support have multiple chronic health conditions, may live in poverty, and have challenges getting their basic needs met, such as food and housing. The team is 100 percent field-based and every day they show up and not only listen and support our members, but are willing to share pieces of their own story to inspire hope and change. The results have been nothing less than extraordinary. We’ve seen decreased inpatient days and a reduction in healthcare spending, but more importantly, members are re-engaging in their community and reaching goals related to their health and wellness. We bear witness to life change as members discover their power and break through barriers to accomplish what had once been buried dreams.

These potentially life changing interactions happen every single day with our staff and the members they touch. There are a lot of examples of member success stories, but here are two that underscore the power of peer support:

• Kevin’s low self-esteem led him to live a very unhappy and socially reclusive life. Driven by fear of the world and feelings of being uncared for, Kevin attempted suicide. Thanks to the support provided by Magellan Complete Care through a peer specialist that visits him weekly, Kevin now lives a positive and socially involved life. He enjoys spending time with his new friends and communicating with his peer specialist.
• Joe struggled with debilitating challenges such as depression, suicidal attempts, chronic homelessness, wheelchair-boundedness, severe eye health problems, frequent hospital admissions, inconsistent medication usage and medical follow-ups. Magellan Complete Care worked with Joe to move toward the road to recovery through a complex case management program with a care coordination team and a peer support specialist. The team linked Joe to medical and psychiatric providers, a mental health agency and helped him obtain an independent living facility, food stamps, a new wheelchair, phone, eye glasses, and transportation assistance to attend appointments and follow-ups. Magellan Complete Care also assisted Joe in obtaining a referral for a prosthetic leg. Magellan then linked Joe with a job agency to support his goal of acquiring a job.

The members’ feelings of hope, pride, and self-confidence are contagious and we share these feelings when we reflect on the difference the health plan and staff makes in members lives. Our members are changing their own lives, but ours are changing along with them.

To mark Mental Health Month, we had the opportunity to sit down with Dr. Caroline Carney, chief medical officer of Magellan Healthcare. Dr. Carney shed some light on stigma, barriers to mental health services and ways we can all help all friends and family get the treatment they need to live a healthy, vibrant life.

Why is there still a stigma around seeking help or treatment for mental health concerns?

Dr. Carney: I think we first need to talk about what stigma is, and where it comes from.

Unfortunately, people with mental illness have been stigmatized by others, and even by themselves. Mental illness is often still perceived as an indulgence, a sign of weakness, or as a character weakness. You also may find people who believe mental illness is something that is scary, or to be made fun of. So many myths exist about mental illness, including that it is the result of bad parenting. Popular culture continues to further the stereotypes and myths.

Further, self-stigmatization is a huge driver for this. Self-stigmatization occurs when shame and secrecy override even the most extreme of symptoms, preventing people from getting the help they need. Few people recognize how prevalent mental illness is.  We don’t talk about depression. We don’t talk about our own perceived failures. We don’t talk about how tough life can be, and often suffer through it in silence. Further, the symptoms themselves, whether depression, anxiety or psychotic disorders, often contribute to a sense of isolation. In the time of Facebook and Instagram, we are led to believe that everyone lives a happy and interesting life every day. If you feel you don’t measure up to what is shown on social media, it can then be perceived as a failure. This is especially true for adolescents, teens and college-aged kids. I’ve spoken recently to a young person who was afraid to talk to her best friend and to her mentor about her feelings of depression and loneliness. She was afraid they would think that she was weak and flawed—therefore not worthy of being a good friend. Instead, she suffered in silence, further worsening the symptoms until suicide became part of her daily thoughts. Most people around her would never recognize this incredible kid regularly thinks of suicide. This, unfortunately, is an all too common scenario.

What can friends, family and coworkers do to help lessen that stigma and encourage people to seek help?

Dr. Carney: I think the biggest step is to support and withhold judgement. Family and friends need to be upfront about symptoms or conditions they’ve had in their own lives. I often advise that it is a normal, common thing to get treatment—it should be considered no different than getting treated for any medical condition. In some cases, friends and family may find themselves helping someone access treatment at a mental health provider or a primary care physician. Emphasizing that mental illness isn’t a sign of failure, and can actually be treated, is critically important. As a doctor, I have often counseled the loved ones of my patients that it can be frustrating to take care of a person in the thick of an episode of mental illness. The symptoms of depression, for instance, dampen ones motivation, support beliefs of hopelessness, and take away energy. It should be no surprise, then, that the person suffering from mental illness doesn’t want therapy. Don’t give up on them—understand that the disease itself influences getting treatment.

Treatment for mental illness doesn’t happen overnight—it can often take weeks or even longer for a response to occur. Family, friends, coworkers, and providers shouldn’t give up.  Look for incremental change, not overnight cures.

What is the biggest misperception about mental illness? 

Dr. Carney: The biggest misperception is that mental illness isn’t an illness—that is something one brings upon oneself. Mental illness is caused by biological, genetic, and environmental factors.

Can you live a life of recovery?

Dr. Carney: Absolutely! Because mental illness is a medical condition, it’s important to know about different mental conditions and their associated treatment options. A common myth is that the illness will go away if a stressor is removed, or time passes, or a person just thinks positive thoughts or prays. Think about a physical illness such as diabetes. Diabetes won’t go away with positive thinking, and neither will a condition like depression. Mental illness can be treated, and the earlier treatment is initiated, the better the chances of recovery. Finding licensed, trained providers is essential. Using social supports like faith or your peers can be an extension of, not a replacement for, treatment.  Importantly, having an episode of depression or an anxiety disorder may only occur once in a lifetime. If the root causes are uncovered, cognitive distortions are addressed, and if appropriate, medication used correctly, the morbidity of mental illness can be markedly reduced, and may never come back. Even people with serious persistent mental illness, such as schizophrenia, can live a life of recovery with the right supports and treatment.

But I also think it’s essential that we need to educate people that the illness may return. This doesn’t mean that a person with mental illness failed. It means that the illness may be chronic, but the symptoms can still be treated.

The most vital concept to remember is that recovery is possible, and can be permanent.  When it’s not permanent, treatment can be ongoing and very successful.

What can providers/clinicians do to help reduce stigma?

Dr. Carney: I think there are a few ways that everyone – not only providers or clinicians – can help counter stigma around mental illness.

• Know the facts about mental illness—read about mental illness from expert and advocacy groups like the National Alliance on Mental Illness (NAMI), the National Institute of Mental Health, the Substance Abuse and Mental Health Services Administration (SAMHSA) and other sites.  Rumor and innuendo never serve the facts.
• Continue to reinforce that this is an illness, and not a sign of weakness or failure.
• Take a look at your own attitudes and how you think about mental illness—whether your own, in someone you care about or the stranger you see on the street.  Understand that no one would ever want to be depressed, or be troubled by hallucinations. Mental illness is an illness, no less than heart disease or cancer.
• Choose your words carefully—Often we refer to someone who has diabetes as a diabetic, or a person with schizophrenia as a schizophrenic. People are more than their disease, whatever it may be. We need to preserve personal dignity by recognizing that our words matter—use terms like “he is a man with schizophrenia,” and be mindful of common phrases like “crazy” or “nuts.”
• Provide support by keeping your loved one or friend safe from harm. Participate in therapy when asked. Avoid passing judgement, especially about how quickly someone’s recovery may be progressing, and continue to support the receipt of treatment.
• Take an honest look about what environmental factors may be contributing to the illness.  Evaluate short-term and long-term stressors.  Just like we would monitor the diet for someone with diabetes, we should recognize that environmental factors contribute to mental illness, just as they do to physical health.
• Never accept or foster stereotypes.